This document summarizes a presentation on measuring outpatient healthcare use in the VA system. It discusses challenges in measurement, key VA outpatient databases, and strategies for evaluating different aspects of outpatient care such as procedures, provider specialty, and care over time. The Medical SAS outpatient datasets and DSS National Data Extract files are described as primary sources for measuring outpatient visits, procedures, and diagnoses. Examples are given of studies that measured intensity of care, care concomitant with inpatient stays, and trends in outpatient vs inpatient utilization over time.

1. VIReC Cyber Seminar Series 2006 VA Databases and Methods Assessing VA Outpatient Healthcare Use Presented by Denise M. Hynes, Ph.D., R.N. Director, VA Information Resource Center Research Health Scientist, MCHSPR COE

7. VA Outpatient Data Flow to the Med SAS Datasets

8. VA Medical SAS Outpatient Datasets 1990 - 2001 SC Procedure 1997 – 2001 SG Diagnosis 1998 – present SE Event 1980 - present SF Visit Dates Reference File

30. From: Maciejewski ML and Maynard CM. Diabetes-Related Utilization and Costs for Inpatient and Outpatient Services in the Veterans Administration. Diabetes . 2004: 27(suppl 2):B69-B73. OPC-SE OPC SC since FY90 OPC DX started in 1997 OPC-SF-back to 1980 But no DX field to identify the DM cases Outpatient Care Over Time Example from Maciejewski and Maynard, 2004